IS COLOR DOPPLER ULTRASOUND A SENSITIVE SCREENING METHOD IN DIAGNOSING DEEP-VEIN THROMBOSIS AFTER HIP-SURGERY

Patients undergoing orthopedic surgery are at high risk of developing deep vein thrombosis. One hundred and thirty-eight consecutive patient s undergoing total hip replacement or hip fracture surgery were includ ed in this study, They were surveilled with colour Doppler ultrasound (CDU) and bilateral ascending contrast phlebography. The prevalence of proximal and distal DVT in this study was 5.8% and 20.3% respectively . CDU has a satisfactory sensitivity in patients with symptomatic deep vein thrombosis, especially in the proximal region. These results cou ld not be confirmed in the present study of asymptomatic patients. The sensitivity was 62.5% (95% confidence interval: C.I. 24-91%) and the specificity 99.6% (C.I. 98-100%) for proximal DVT; 53.6% (C.I. 34-73%) and 98% (C.I. 96-99%) respectively for distal thrombi. The overall se nsitivity was 58.1% (C.I. 39-75%) and the specificity 98% (C.I. 96-99% ). The positive predictive value was 83.3% (C.I. 36-99%) and 75% (C.I. 51-91%) for proximal and distal DVT respectively. The negative predic tive value was 98.99% (C.I. 98-100%) and 94.9% (C.I. 92-98%) for proxi mal and distal DVT respectively. The results of this study showed that even with a highly specialised and experienced investigator the sensi tivity of CDU was too low to make it suitable for screening purposes i n a high risk surgical population.